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Euthanasia (Greek, “easy death”) is the act of inducing a gentle, painless death. In recent decades the term has come to mean deliberately terminating life to prevent unavoidable suffering. Passive euthanasia is discontinuing life-sustaining treatment of the ill or stopping so-called extraordinary treatment. Active euthanasia, or mercy killing, is putting to death a person who, due to disease or extreme age, can no longer lead a meaningful life; the term can also include an act of voluntary euthanasia, or SUICIDE, for similar reasons.(Mullen, 11)
Active euthanasia-The deliberate termination of the life of a human being who is ill.
Passive euthanasia-The withholding or withdrawal of treatment for a patient where the disease is terminal, and where treatment is futile.
Voluntary euthanasia-Requires consent of the patient.
Physician-assisted euthanasia-Same as active euthanasia but the doctor isn t necessarily present at the time of death.
The deliberate taking of a suffering person s life without the persons explicit request.
Alleviation of pain and symptoms
The administration of painkillers, usually morphine, with the intent to ease a dying patient s pain and remove distress symptoms with the understanding the drug may unintentionally hasten the patient s death
Should doctor-assisted suicide be made legal or prohibited by law?
Legally permitted 70%
*The results of a telephone poll
(In class handout)
Based on these results we can see that Canadians support Euthanasia.
Many physicians consider it good medical practice not to artificially prolong the life of a suffering person whose disease is inevitably fatal. Instead, they provide comfort and relief while the patient awaits death. Passive euthanasia, however, has only recently gained legal support. In 1976, the New Jersey Supreme Court ruled that doctors may disconnect a mechanical respirator that is keeping a comatose patient alive because it prevents the patient from dying with decency and dignity. In 1977, “right to die” bills were introduced into several state legislatures. Since then, more than 30 states have passed laws that confer the authority to withdraw life support from a patient upon a designated relative, friend, legal or religious advisor, or court. In 1990 the U.S. Supreme Court ruled that people who make their wishes known have a constitutional right to have life-sustaining treatment discontinued. In the cases of permanently unconscious persons who have left no clear instructions, however, the state may deny the request by family members to terminate treatment. This ruling gave legal backing to the living will, which provides evidence of a person’s desire not to be kept alive by artificial means should that person become terminally ill and incompetent.(Oosthuizen, 147)
Free Inquiry: “So, not leaving the respirator on, pulling the plug-that s not a good death?”
Jack Kevorkian: “Gasping for air? Starving and thirsting to death? Like Nancy Cruzan: it took her a week to die. Try it! You think that just because you re in a coma you don t suffer?”(McCuen, 33)
Passive euthanasia continues to raise many legal problems, however, such as in cases in which parents and doctors decide not to pursue drastic life-saving measures for children born with severe birth defects. An enduring ethical question is also raised by the Hippocratic oath, which requires physicians both to relieve suffering and to prolong life. The problem is intensified because the definition of death has become blurred. Formerly a person was considered dead when breathing and heart action ceased. Since these functions can be maintained artificially now, a definition of death that includes brain death–lack of electrical activity for a period long enough to make return to functioning virtually impossible–is widely accepted.
In the United States active euthanasia is a serious crime, punishable by life imprisonment. Some doctors are helping terminally ill patients commit suicide–a so-called physician-assisted suicide–without being punished. In some countries active euthanasia is a special crime with lighter penalties, and in Uruguay it is not a crime. In the Netherlands, doctors are not prosecuted if they follow specific guidelines on euthanasia. A 1992 survey showed that not all doctors were following the guidelines and thus were committing involuntary euthanasia on some patients.(Beauchamp, 91)
+ Do human beings have the right to control the circumstance of their deaths or should that be left to God or nature?
+ What is the role of law or government in enforcing public morality or accommodating moral choice?
+ Can a legislative system respect individual autonomy yet at the same time protect those who are less able to exercise their autonomy-the mentally incompetent or ill, the disable, the elderly, the socially disadvantaged, the depressed?
+ If we give doctors the power to end our lives, will it erode the ethos of the medical profession, shift the nature of the doctor-patient relationship, or undermine the commitment to optimal care for the dying?
+ Does the medical profession event want the responsibility of helping patient die?
+ If we acknowledge that euthanasia can be of benefit to those who are suffering and who request it, will we impose this “benefit” on those who are suffering or disable who can t request it – or worse, who would not request it?
+ Is it possible to establish the right to die but not create the obligation to die, placing overt or subtle pressure on individuals who feel they might be a burden on their families?
+ Is it possible to devise safe and effective legislation to control an agreement that takes place privately between patient and doctor, and after the death, may only come light if the doctor reveals it?(Mullens, 4)
As never before technology is able to save and prolong life and cure disease, some times in very dramatic ways. But there s a reverse side. It is often used inappropriately and at a high price. People can become victims of technology and have their dying prolonged beyond what is reasonable or their life is extended at an extremely low quality. Medical technology can burden people with machines, procedures, tubes, and medications rather then enhance their well-being.
Medicine cannot cure all diseases, or even suppress or alleviate the symptoms of some diseases. People fear;
1. mental deterioration
2. the wasting away of their bodies
3. the embarrassment of disfigurement
4. the sapping of energy
5. the loss of control and the ability to do things for themselves
6. the physical pain
7. the many forms of psychological punishment.
“Euthanasia can do what medicine can t.”
“Euthanasia might be seen as a way of achieving what medicine can t.”
The decision to stop treatment is really a decision to stop doing what is no longer of real benefit to the patient and what has become unreasonably burdensome, in order to allow nature to run it s course. (Hamel, 40)
1. Death is not an absolute evil to be avoided at all costs and in all circumstances, and life is not an absolute good to be preserved and maintained at all costs.
2. Human life is more than biological functioning. It includes self-awareness and the ability to reason, emote, communicate, decide, and attach meaning-at least at some level.
3. Keeping a human being alive against his or her own will after all dignity, appreciation, and meaning of life have ceased and any benefit to anyone is impossible is cruel and dehumanizing (Canadian Charter of Rights and Freedoms, Section 12 says there should be no cruel or unusual treatment or punishment).
4. Individuals have the right to a dignified and gentle death when faced with incurable and painful illness (Section 7 of the Charter, “right to life”; does that mean the right to a dignified death).(Carmi, 99)
Don t doctors have the responsibility with the community, not only to be aware of the severity of incurable diseases and the impact which it has on the lives of the persons around the patient, but have the responsibility to prevent disease, pain and suffering?(van der Mass, 52)
“Occasions of suffering are a part of life” – Davidson, 1975
“Life is so constituted that there is no progress without pain” – Gittelson, 1955 (Carmi, 21)
Suffering may be accepted as a part of life; however, suffering should not fill one s whole life.
The guidelines in the Netherlands for euthanasia are as follows:
+ The patient has made a persistent, voluntary and durable request.
+ The patient has full information on his or her condition.
+ There is unacceptable and hopeless suffering, but not necessarily a terminal illness.
+ Any alternative treatments are found wanting.
+ The euthanasia is performed only by a physician after consulting with a second physician who confirms the decision.
+ The doctor does not issue a certificate of natural death, but fills out a 60-point questionnaire and calls the coroner, who comes to the home to view the body and verify the facts. The corner then files a report with the local prosecutor who decides whether charges will be laid.(Mullen, 20)
In 1980 Canada turned its back on a century of legal history, on its customs, conventions, and traditions. The Supreme Court of Canada not God decided the faith of a 42 year old British Columbia woman suffering from Lou Gehrig s disease.
Section 241 of the Criminal Code of Canada makes it an indictable offence to counsel, aid, or abet anyone to commit suicide. Since 1972 attempted suicide has not in itself been a criminal offence in Canada.
Sue Rodriguez had no wish to counsel, aid, or abet anyone to commit suicide. Simply she wanted someone to violate that law by assisting her to die, and she wanted a declaration of judicial immunity in advance.
It is important to understand that Sue Rodriguez did not wish to die. She wanted to wait until she was no longer able to enjoy life, at which time, because of the inexorable physical degeneration that characterizes Lou Gehrig s disease, self -destruction would be beyond her. She wanted a court order that would allow someone to provide the means and assist her in taking her life at a time of her choosing “Dying with Dignity”. (Gentles, 29)
Rodriguez s challenge to section 241 of the Criminal Code was based on three sections of the Charter:
1. Section 7-Everyone has the right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice. Rodriguez argues that this right to life also includes the right to a dignified death.
2. Section 12-Everyone has the right not to be subjected to any cruel and unusual punishment. Rodriguez contends that having to endure ALS is cruel and unusual.
3. Section 15-(1)Every individual is equal before and under the law and has the right to equal protection and equal benefit of the law without discrimination based on race, national or ethnic origin, color, religion, sex, age or mental or physical disability. Rodriguez contends that because she is too incapacitated to commit suicide herself, and suicide in not a crime, that she is being discriminated against because she cannot legally have assistance to end her life.(Mullens, 13 and Gentles, 30)
The Supreme Court of Canada denied Sue Rodriguez a legal right for assisted suicide.
Author- A. Carmi
Author- Ian Gentles
Title- Euthanasia And Assisted Suicide
Author- Ron Hamel
Title- Choosing Death
Author- Gary E. McCuen
Title- Doctor Assisted Suicide And The Euthanasia Movement
Author- Anne Mullens
Title- Euthanasia: Dying for leadership
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